Very-low-calorie diet

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Very low calorie diet (VLCD), or sometimes called starvation diet,[1][2] is a diet with very or extremely low daily food energy consumption. It is defined as a diet of 800 kilocalories (3,300 kJ) per day or less. VLCDs are formulated, nutritionally complete, liquid meals containing 800 kilocalories or less per day. VLCDs also contain the recommended daily requirements for vitamins, minerals, trace elements, fatty acids and protein. Carbohydrate may be entirely absent, or substituted for a portion of the protein; this choice has important metabolic effects.[3] The VLCD products are usually a powder which is mixed with water or another low-food-energy liquid. The VLCD is prescribed on a case to case basis for rapid weight loss (about 1.5 to 2.5 kilograms or 3 to 5 pounds per week) in people with body mass index (BMI) of 30 and above. The health care provider can recommend the diet to a patient with a BMI between 27 and 30 if the medical complications the patient has due to being overweight present serious health risks.[4] It results in 4% more weight loss over the short term as compared to control.[5]


A VLCD is typically undertaken by an obese patient who wishes to lose a lot of weight quickly, as the risk to health that obesity presents is considered much greater than any risks of the diet itself, so long as it is undertaken with medical supervision.[6][dead link][citation needed]

Health effects[edit]

VLCDs have been shown to be more effective than behavioural weight loss programmes, achieving approximately 4 kg more weight loss at 1 year.[7] When used in routine care, there is evidence that VLCDs achieve average weight loss at 1 year around 10 kg.[8] In about one in four individuals following a VLCD for a few months, gallstones develop. However, these gallstones may be small enough to not cause discomfort, and often disappear when a normal eating pattern is resumed.[9][10][11] Gallstone formation is facilitated by the more concentrated bile fluid and reduced flow as a result of a VLCD.[12]

Another potential side effect is constipation (depending on the fiber content of the diet).[13][14] Unmonitored VLCDs with insufficient macronutrient and mineral intake have the potential to cause sudden death via ventricular tachycardia.[15][16]

See also[edit]


  1. ^ Johnstone A (May 2015). "Fasting for weight loss: an effective strategy or latest dieting trend?". International Journal of Obesity. 39 (5): 727–33. doi:10.1038/ijo.2014.214. PMID 25540982.
  2. ^ Fletcher V (4 August 2012). "Warning: This article tells you a starvation diet could actually be good for you - and make you live longer". Mail Online. Retrieved 2 August 2018.
  3. ^ Howard AN (1981). "The historical development, efficacy and safety of very-low-calorie diets". International Journal of Obesity. 5 (3): 195–208. PMID 7024153.
  4. ^ "Very Low Calorie Diet for Rapid Weight Loss". Calorie Counter. Retrieved 2010-10-19.
  5. ^ Gudzune KA, Doshi RS, Mehta AK, Chaudhry ZW, Jacobs DK, Vakil RM, Lee CJ, Bleich SN, Clark JM (April 2015). "Efficacy of commercial weight-loss programs: an updated systematic review". Annals of Internal Medicine. 162 (7): 501–12. doi:10.7326/m14-2238. PMC 4446719. PMID 25844997.
  6. ^ Diabetes for Professionals – VLCD in the treatment of obese patients with Type 2 diabetes: does it make sense?
  7. ^ Parretti HM, Jebb SA, Johns DJ, Lewis AL, Christian-Brown AM, Aveyard P (March 2016). "Clinical effectiveness of very-low-energy diets in the management of weight loss: a systematic review and meta-analysis of randomized controlled trials". Obesity Reviews. 17 (3): 225–34. doi:10.1111/obr.12366. PMID 26775902.
  8. ^ Astbury NM, Aveyard P, Nickless A, Hood K, Corfield K, Lowe R, Jebb SA (September 2018). "Doctor Referral of Overweight People to Low Energy total diet replacement Treatment (DROPLET): pragmatic randomised controlled trial". BMJ. 362: k3760. doi:10.1136/bmj.k3760. PMC 6156558. PMID 30257983.
  9. ^ Andersen T (July 1992). "Liver and gallbladder disease before and after very-low-calorie diets". The American Journal of Clinical Nutrition. 56 (1 Suppl): 235S–239S. doi:10.1093/ajcn/56.1.235S. PMID 1615889.
  10. ^ Broomfield PH, Chopra R, Sheinbaum RC, Bonorris GG, Silverman A, Schoenfield LJ, Marks JW (December 1988). "Effects of ursodeoxycholic acid and aspirin on the formation of lithogenic bile and gallstones during loss of weight". The New England Journal of Medicine. 319 (24): 1567–72. doi:10.1056/NEJM198812153192403. PMID 3200265.
  11. ^ Liddle RA, Goldstein RB, Saxton J (August 1989). "Gallstone formation during weight-reduction dieting". Archives of Internal Medicine. 149 (8): 1750–3. doi:10.1001/archinte.1989.00390080036009. PMID 2669662.
  12. ^ "Prevention—Gallstones". National Health Service. 10 October 2018.
  13. ^ Astrup A, Vrist E, Quaade F (February 1990). "Dietary fibre added to very low calorie diet reduces hunger and alleviates constipation". International Journal of Obesity. 14 (2): 105–12. PMID 2160441.
  14. ^ Astrup A, Quaade F (1989). "VLCD compliance and lean body mass". International Journal of Obesity. 13 Suppl 2: 27–31. PMID 2559044.
  15. ^ Isner JM, Sours HE, Paris AL, Ferrans VJ, Roberts WC (December 1979). "Sudden, unexpected death in avid dieters using the liquid-protein-modified-fast diet. Observations in 17 patients and the role of the prolonged QT interval". Circulation. 60 (6): 1401–12. doi:10.1161/01.cir.60.6.1401. PMID 498466.
  16. ^ Sours HE, Frattali VP, Brand CD, Feldman RA, Forbes AL, Swanson RC, Paris AL (April 1981). "Sudden death associated with very low calorie weight reduction regimens". The American Journal of Clinical Nutrition. 34 (4): 453–61. doi:10.1093/ajcn/34.4.453. PMID 7223697.

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